Clinicopathological featuers of gastric adenocarcinoma of fundic gland type

JIANG Qiu-li; LIU Kun; ZHOU Ying; LU Hua-dong

doi:10.3969/j.issn.1007-8096.2025.01.008

Abstract：Objective To observe and analyze the clinical manifestations and pathological features of gastric adenocarcinoma of fundic gland type(GA-FG).Methods A retrospective analysis was conducted on six GA-FG cases archived from January 2018 to January 2024 at Zhongshan Hospital(Xiamen),Fudan University.Clinical data including gender,age,symptoms,signs,lesion location,and endoscopic features were collected and analyzed.Two experienced pathologists reviewed HE and immunohistochemical slides to verify diagnosis.Results The patients were aged between 45 and 66 years,with a male-to-female ratio of 2∶1.The primary symptoms were abdominal distension,abdominal pain,and acid reflux,with no significant family history of tumors.Three patients had a history of proton pump inhibitor use,two had used H2 receptor antagonists.The lesions were predominantly located in the gastric body and fundus,with tumor diameters ranging from 0.3 to 1.2 cm and invasion depths from 50 to 500 μm.Endoscopically,lesions appeared as submucosal protrusions,predominantly Paris type 0-Ⅱa,and were negative for Helicobacter pylori.Pathologically,tumors showed glandular distortion and labyrinth-like patterns,composed of columnar cells similar to fundic gland chief cells,with positive MUC6 and pepsinogen I staining.No atrophy,intestinal metaplasia,or vascular invasion was observed.Follow-up of 13-32 months showed no recurrence or metastasis.Conclusion GA-FG is a novel and rare type of gastric adenocarcinoma with low malignancy,primarily invading the submucosa,and is Helicobacter pylori negative.It generally has a good prognosis.Diagnosis should be based on endoscopic features,histological morphology,and immunophenotype.